BCBSTHiring

Provider Quality Consultant

  • Remote, United States
  • Mid-level
  • Posted 5 days ago
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In one line

Consulting role linking provider groups with a state Medicaid quality programme; remote with travel up to a fifth of the time.

About the role

Remote, with up to 20% travel to provider offices. Sits between clinics, managed care partners and programme stakeholders to run quality and value-based care work.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, United States
Seniority
Mid-level
Skills
HEDIS, PCMH, NCQA Recognition, Clinical Data Exchange, EHRs, Value-based care
Posted
30 Oct 2026
Last checked
2 Nov 2026

What you will do

  • Act as the main contact for provider groups taking part in the quality programme.
  • Run implementation, design workflows, handle contracts and chair governance meetings.
  • Visit provider offices in person or online and advise on quality measures and reporting.
  • Track programme performance and push recommendations that lift quality and productivity.

What they look for

  • Three or more years in clinical work, public health, healthcare administration or community outreach.
  • Three or more years on HEDIS or quality improvement, including data analysis and provider education.
  • Bachelor's degree in a health field or equal work experience.
  • Record of building provider relationships and leading quality improvement efforts.
  • Comfort with EHRs and clinical data exchange tools.

Nice to have

  • Advanced degree in healthcare management, public health or business.
  • Experience serving vulnerable populations.

A typical week

  • Provider office visits, in person or virtual, as subject-matter consultant.
  • Meetings with member-facing and provider-facing teams on pay-for-quality programmes.
  • Education sessions for internal and external stakeholders on quality best practices.

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Questions about this job

Is this a remote job, and where can I work from?

Yes. The posting lists Provider Quality Consultant as a remote role for candidates in the United States.

What does this job pay?

No pay range is stated in the posting.

What experience is needed?

It is a mid-level role. The posting asks for: three or more years in clinical work, public health, healthcare administration or community outreach; three or more years on HEDIS or quality improvement, including data analysis and provider education; bachelor's degree in a health field or equal work experience. Skills it names include HEDIS, PCMH, NCQA Recognition, Clinical Data Exchange.

How do I apply with Keywordise AI?

Select Apply with Keywordise AI, sign up and upload your CV. Keywordise writes a CV and a cover letter for this job from your real experience and applies for you. The 7-day free trial needs no card.

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